A rift within the Republican Party deepened this week after House Speaker Mike Johnson (R-LA) announced that GOP leadership would not move forward with proposed Medicaid funding cuts, prompting a sharp public response from Texas Rep. Chip Roy.
The controversy erupted after Johnson emerged from a closed-door meeting with moderate House Republicans and revealed that party leaders had ruled out two key cost-cutting measures: reducing the Federal Medical Assistance Percentage (FMAP) for Medicaid expansion states and implementing per capita caps on Medicaid spending.
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According to Punchbowl News reporter Laura Weiss, Johnson stated, “On per capita caps, which some mods oppose: ‘I think we’re ruling that out as well but stay tuned.’” These two measures, if enacted, could have significantly reduced federal Medicaid support for states that expanded coverage under the Affordable Care Act.
Critics warned that such moves would likely have forced states to cut benefits or reduce enrollment, placing millions of low-income Americans at risk of losing healthcare coverage.
Moderate Republicans have consistently pushed back against efforts that could jeopardize Medicaid access for vulnerable populations, arguing that political fallout and real-world consequences would outweigh any fiscal benefit. Johnson’s remarks appeared to signal a shift in strategy, aimed at maintaining party unity and avoiding internal conflict.
However, that unity was quickly called into question. Rep. Chip Roy (R-TX), a vocal conservative aligned with much of the MAGA movement but also known for bucking GOP leadership, took to social media to challenge Johnson’s decision. “Well—I haven’t ruled it out. It’s necessary to stop robbing the vulnerable to fund the able-bodied,” Roy wrote, directly contradicting the Speaker’s position.
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Roy’s statement underscores a long-standing tension within the Republican Party between fiscal hardliners and more centrist lawmakers over entitlement reform and healthcare spending. While some conservatives advocate deep cuts to federal programs to reduce the deficit, moderates fear the social and political backlash of rolling back popular initiatives like Medicaid expansion.
The public rift didn’t go unnoticed. Punchbowl News co-founder Jake Sherman weighed in on the dispute, sarcastically remarking, “Everything’s going really well.”
As the House GOP continues negotiations over budget priorities, the Medicaid debate is likely to remain a flashpoint, especially with the 2024 election season heating up. With Speaker Johnson attempting to maintain balance between ideological factions, further infighting could complicate legislative progress on health care and federal spending.
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